Novi Cats Health Screening Survey
In accordance with the Oakland County Health Department and the CDC, all staff and players must complete a health screening prior to reporting.  A new screening must be completed each time any staff and players reports to practice.

Important: This screener must be filled out daily within 4 hours of participating in Open Gym, Training, Practice, Games, etc.
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Participant's Last Name *
Participant's First Name *
Participant's Grade *
Parent/Guardian's Name *
Phone Number *
1. Are you Currently experiencing ONE or more of the following symptoms unrelated to a known pre-existing condition (e.g. asthma, allergies)? *
Yes
No
New Cough
Shortness of Breath
Difficulty Breathing
Loss of Taste or Smell
If you are experiencing one or more of the symptoms in question 1, stay home, consult your medical provider, and get tested for COVID-19.
2. Are you currently experiencing TWO or more of the following symptoms unrelated to a known pre-existing condition (e.g. asthma, allergies)?? *
Yes
No
Fever (over 100.4 degrees F)
Chills (rigors)
Muscle Aches (myalgias)
Headache
Sore Throat
Fatigue
Diarrhea (2x in 24 hours)
Nausea or Vomiting (2x in 24 hours)
Congestion or runny nose
If you are experiencing two or more of the symptoms from question 2, stay home, consult your medical provider, and get tested for COVID-19. You may return to work/school after being fever free for 24 hours without taking fever reducing medication and symptoms have improved.
3. Have you been in close contact (within 6 ft for 15 minutes or greater) with anyone (including household members) who has a positive COVID-19 diagnostic test in the past 14 days? *
If you answered yes to question 3, the CDC requires a 10 day quarantine for the last date of exposure.
If YOU have tested positive for COVID-19, the CDC requires a 10 day quarantine.
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